盆腔炎性疾病后遗症患者外周血miR-34a、SIRT1的表达及临床意义

Expressions and clinical significance of miR-34a and SIRT1 in peripheral blood of patients with chronic pelvic inflammatory disease

目的探究盆腔炎性疾病后遗症患者外周血微小RNA-34a(miR-34a)、沉默信息调节因子1(SIRT1)的表达及临床意义。方法回顾性选取2017年8月至2019年11月河北中石油中心医院收治的136例盆腔炎性疾病后遗症患者为观察组,同期140例体检健康的妇女为对照组。实时荧光定量PCR(qRT-PCR)法检测血清miR-34a、SIRT1水平;酶联免疫吸附试验法检测两组血清白细胞介素4(IL-4)、白细胞介素1β(IL-1β)及肿瘤坏死因子-α(TNF-α)水平;Pearson法分析患者血清miR-34a、SIRT1水平间及与血清IL-4、IL-1β、TNF-α水平的相关性;多因素Logistic回归分析影响盆腔炎性疾病后遗症发生的因素。结果观察组患者血清miR-34a、IL-1β、TNF-α水平为1.42±0.33、(139.17±44.15)pg/mL、(79.52±25.24)pg/mL,显著高于对照组[1.01±0.22、(77.86±21.54)pg/mL、(46.61±13.79)pg/mL],SIRT1、IL-4水平为(33.26±8.53)pg/mL、0.69±0.18,显著低于对照组[(48.68±13.22)pg/mL、1.03±0.23],差异均有统计学意义(P<0.05)。血清miR-34a、IL-1β、TNF-α水平为影响盆腔炎性疾病后遗症发生的危险因素(P<0.05),血清SIRT1、IL-4水平为影响盆腔炎性疾病后遗症发生的保护因素(P<0.05)。盆腔炎性疾病后遗症患者血清miR-34a水平与IL-4水平呈显著负相关(r=-0.518,P<0.05),与IL-1β、TNF-α水平均呈显著正相关(r=0.459、0.564,P<0.05);血清SIRT1水平与IL-4水平呈正相关(r=0.462,P<0.05),与IL-1β、TNF-α水平呈负相关(r=-0.541、-0.550,P<0.05);血清miR-34a水平与SIRT1水平呈显著负相关(r=-0.538,P<0.05)。结论盆腔炎性疾病后遗症患者血清miR-34a水平升高,SIRT1水平降低,二者均与炎症因子水平密切相关,可能通过影响炎症反应共同参与盆腔炎性疾病后遗症发生,可为盆腔炎性疾病后遗症防治过程中炎症反应的调控提供一定参考。

Objective To investigate the expressions and clinical significance of microRNA-34a(miR-34a)and SIRT1 in peripheral blood of patients with chronic pelvic inflammation.Methods A total of 136 patients with chronic pelvic inflammatory disease who admitted to Hebei Petrochina Central Hospital were retrospectively selected as the observation group from August 2017 to November 2019,and 140 healthy women were selected as the control group.The levels of serum miR-34a and SIRT1 were detected by real-time fluorescent quantitative PCR(qRT-PCR);the levels of serum interleukin-4(IL-4),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA);Pearson's method was used to analyze the correlations between serum miR-34a,SIRT1 levels and serum IL-4,IL-1βlevels,the correlation between serum TNF-αlevel and SIRT1;and multivariate Logistic regression was used to analyze the factors affecting the occurrence of chronic pelvic inflammation.Results The serum levels of miR-34a,IL-1βand TNF-αin the observation group were 1.42±0.33,(139.17±44.15)pg/mL,(79.52±25.24)pg/mL,which were significantly higher than those in the control group[1.01±0.22,(77.86±21.54)pg/mL,(46.61±13.79)pg/mL],the levels of SIRT1,IL-4 were(33.26±8.53)pg/mL,0.69±0.18,which were significantly lower than those in the control group[(48.68±13.22)pg/mL,1.03±0.23],the differences were statistically significant(P<0.05).The levels of serum miR-34a,IL-1β,TNF-αwere the risk factors of chronic pelvic inflammation(P<0.05),and the levels of serum SIRT1 and IL-4 were the protective factors(P<0.05).The level of serum miR-34a in patients with chronic pelvic inflammation was negatively correlated with the level of IL-4(r=-0.518,P<0.05),and positively correlated with the levels of IL-1βand TNF-α(r=0.459,0.564;P<0.05);the level of serum SIRT1 was positively correlated with IL-4(r=0.462,P<0.05),and negatively correlated with IL-1β,TNF-α(r=-0.541,-0.550;P<0.05);and there was a significant negative correlation between serum miR-34a and SIRT1(r=-0.538,P<0.05).Conclusion The level of serum miR-34a in patients with chronic pelvic inflammation is increased,the level of SIRT1 is decreased,and both of them are closely related to the level of inflammatory factors.They may participate in the occurrence of chronic pelvic inflammation by influencing the inflammatory response,which can provide some reference for the regulation of inflammatory response in the process of prevention and treatment of chronic pelvic inflammation.